By Gina Shaw
New legislation proposed by Reps. Chip Roy (R-Texas) and Morgan Griffith (R-Va.) would eliminate the National Institute of Allergy and Infectious Diseases (NIAID) in its current form, replacing it with three separate institutes: a National Institute of Allergic Diseases, a National Institute of Infectious Diseases and a National Institute of Immunologic Diseases.
The bill, known as the NIH Reform Act (H.R.1768), was introduced Feb. 21, 2025, and referred to the House Committee on Energy and Commerce. The legislation would require that each institute’s director be appointed by the president and confirmed by the Senate, and be limited to no more than two five-year terms.
A previous proposal to split up NIAID into separate divisions, introduced during the last Congress, drew the ire of the Infectious Disease Society of America (IDSA). The group said that plan’s inefficient, siloed approach “would compromise scientific discoveries.”
The current bill’s sponsors claim the opposite—that the centralized leadership model at the nation’s top health agencies is not working. “As a senior member of the House Committee on Energy and Commerce and the lead Energy and Commerce Member investigating COVID-19 origins, I aggressively pushed to examine the severe inadequacies pervading our public health institutions, such as the National Institutes of Health (NIH),” Mr. Griffith said in a release about the bill. “Through my investigative work, it is clear to me that serious reforms are needed at NIH to resolve these inadequacies and restore Americans’ trust of our public health agencies. The NIH Reform Act is a critical measure to ensure proper agency oversight of biosafety and risky research projects and improve agency accountability to the American people.”
But a leading researcher in infectious disease said the proposal would introduce unnecessary additional bureaucracy—something the Trump administration is slashing as per an executive order signed on Feb. 19—and would be detrimental to scientific progress. “There is a lot to lose and not much to be gained by doing this,” said Stephen Carpenter, MD, PhD, an assistant professor in the Division of Infectious Diseases and HIV Medicine and an assistant professor in the Department of Pathology at Case Western Reserve University School of Medicine, in Cleveland.
“I have a lab that focuses on immune responses to chronic infection with Mycobacterium tuberculosis and other chronic infectious diseases. Our research is at the intersection of immunology and infectious disease, and that is where the most cutting-edge research in infectious disease is happening,” Dr. Carpenter said. “It’s not just the classic study of the bacteria, or study of the immune system; the most innovative work is happening at the intersection. By siloing the institute into three entities, you’re leaving gaps where the most cutting-edge research is happening.”
For example, Dr. Carpenter said if the proposed three-way split of NIAID were put in place, he would not know where to submit his own grant proposals. “If I submitted them to an infectious disease–only institute, the people reviewing them might not have the necessary expertise in the immune response,” he said. “Similarly, if I submitted to an immunology institute, that would also likely not contain the infectious disease expertise needed to review the proposal. This leaves huge gaps in areas where the most important research is being done.”
On the budget side, implementing three director positions where there was previously only one would add costs both for those positions and for management staff, Dr. Carpenter said. “The need for multiple presidential appointments and congressional approvals would also slow down the goals and focus of each institute.”
Is a Smaller NIAID Better?
The earlier proposal to break up NIAID would have shrunk the NIH’s 27 institutes to 15 using what it called a more “holistic” approach, although that plan would have only split NIAID into two separate institutes: an infectious disease institute and one focusing on the immune system and arthritis. In August 2024, the former president of IDSA, Steven K. Schmitt, MD, FIDSA, FACP, and the former president of the HIV Medicine Association, Allison Agwu, MD, outlined detailed concerns about that framework in a letter to one of its champions, Cathy McMorris Rodgers (R-Wash.), the former chair of the Energy and Commerce Committee.
“[W]e are very concerned that the proposal to split the National Institutes of Allergy and Infectious Diseases into two institutes will compromise scientific discoveries by siloing two inter-related areas of research and reducing the efficiency and synergy of collaboration, planning, communication and coordination that comes from them being conducted under one institute,” they wrote.
As for the current plan to split up these agencies, Dr. Carpenter said the move “suggests that politics are being inappropriately introduced into something that should be apolitical—infectious disease, medical research and public health, which are important to everyone in the country.”
He suggested that ID physicians make their voices heard by reaching out to their members of Congress. “I have been making phone calls and emails, and I know my colleagues have as well,” he said. “I work closely with the IDSA on their public policy committee, and we have also been setting up meetings on Capitol Hill in the coming months. We want the NIAID and all of the NIH to be run as well and as efficiently as possible and welcome improvements, but we do not want politics to be interjected into public health.”
